Provider Demographics
NPI:1093314932
Name:POST FALLS ORTHODONTICS PLLC
Entity Type:Organization
Organization Name:POST FALLS ORTHODONTICS PLLC
Other - Org Name:POST FALLS ORTHODONTICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:SHEPHERD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-772-7272
Mailing Address - Street 1:602 N CALGARY CT STE 302
Mailing Address - Street 2:
Mailing Address - City:POST FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83854-4000
Mailing Address - Country:US
Mailing Address - Phone:208-777-0500
Mailing Address - Fax:
Practice Address - Street 1:602 N CALGARY CT STE 302
Practice Address - Street 2:
Practice Address - City:POST FALLS
Practice Address - State:ID
Practice Address - Zip Code:83854-4000
Practice Address - Country:US
Practice Address - Phone:208-777-0500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ERIK R. CURTIS, DDS, MS, PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-10-21
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty